Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.82 / $128.82 / $128.82	Facility	26	$128.82	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $478.63 / $1,047.13	Professional		$338.84	$478.63	$1,047.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $154.88 / $263.03	Professional	26	$70.79	$154.88	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $354.81 / $812.83	Professional	TC	$269.15	$354.81	$812.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $630.96 / $1,230.27	Professional		$316.23	$630.96	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $97.72 / $181.97	Professional	26	$63.10	$97.72	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $489.78 / $1,071.52	Professional	TC	$251.19	$489.78	$1,071.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $776.25	Professional		$32.36	$33.11	$776.25
Regence BlueShield Facility/Professional Facility Modifier 26 Low / Median / High Price $676.08 / $676.08 / $676.08	Facility	26	$676.08	$676.08	$676.08
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $645.65 / $1,258.93	Professional		$478.63	$645.65	$1,258.93
Regence BlueShield Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $128.82 / $199.53	Professional	26	$97.72	$128.82	$199.53
Regence BlueShield Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $512.86 / $1,071.52	Professional	TC	$380.19	$512.86	$1,071.52
Select Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $489.78 / $1,096.48	Professional		$309.03	$489.78	$1,096.48
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $162.18 / $190.55	Professional	26	$66.07	$162.18	$190.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $331.13 / $524.81	Professional	TC	$245.47	$331.13	$524.81
U of Utah Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $426.58 / $707.95	Professional		$97.72	$426.58	$707.95
United Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $524.81 / $977.24	Professional		$323.59	$524.81	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $77.62 / $138.04	Professional	26	$64.57	$77.62	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $446.68 / $758.58	Professional	TC	$257.04	$446.68	$758.58